Oral Dydrogesterone Versus Oral Micronized Progesterone in Threatened Miscarriage: Protocol Paper for a Randomized Controlled Trial.

Threatened miscarriage is a common complication of early pregnancy characterized by symptoms of vaginal bleeding with/without abdominal cramps/pain in the first trimester. Progestogens are often administered for management of this condition. Presented herein is the protocol of an ongoing, multicentric clinical trial to investigate the efficacy and safety of micronized progesterone (natural progestogen) compared to dydrogesterone (synthetic isomer of progesterone).

A Phase III, Double-Blind, Randomized, Multicenter, Clinical Trial to Evaluate the Efficacy and Safety of a Fixed-Dose Combination of Metformin Hydrochloride and Myo-Inositol Compared to Metformin in Patients With Polycystic Ovary Syndrome.

Background Polycystic ovary syndrome (PCOS) poses a significant health concern among reproductive-aged women and is characterized by ovarian dysfunction, hyperandrogenism, and insulin resistance. This study aims to assess the efficacy and safety of metformin and myo-inositol combination therapy compared to metformin monotherapy in patients with PCOS. Materials and methods This was a phase III, double-blind, randomized controlled clinical trial.

Role of primary care in opioid prescribing for older head and neck cancer survivors.

Background: Older head and neck cancer (HNC) survivors have concerning rates of potentially unsafe opioid prescribing. Identifying the specialties of opioid prescribers for HNC survivors is critical for targeting the settings for opioid safety interventions. This study hypothesized that oncology and surgery providers are primarily responsible for opioid prescriptions in the year after treatment but that primary care providers (PCPs) are increasingly involved in prescribing over time.

Pain management for post-treatment survivors of complex cancers: a qualitative study of opioids and cannabis.

We aimed to understand experiences with opioids and cannabis for post-treatment cancer survivors. We conducted seven focus groups among head and neck and lung cancer survivors, using standard qualitative methodology to explore themes around 1) post-treatment pain and 2) utilization, perceived benefits and perceived harms of cannabis and opioids. Survivors (N = 25) experienced addiction fears, stigma and access challenges for both products.

Medullary pyramids opacification in high-grade vesicoureteral reflux associated with posterior urethral valve.

Posterior urethral valve (PUV) is a common cause of obstructive uropathy in children, leading to renal failure and frequently associated with vesicoureteral reflux (VUR), which can rapidly progress to end-stage renal disease (ESRD). We describe a rare presentation of high-grade VUR opacifying the renal pyramids in a 5-month-old child with sepsis and renal failure.

Laparoscopic Cerclage in a Case of Unicornuate Uterus with Cervical Insufficiency and Previous Failed Mc Donald Cerclage with a Successful Outcome: A Case Report.

In this report, we describe a 28-year-old woman, with unicornuate uterus and multiple mid-trimester losses, with two failed Mc Donald's cerclage. She presented to us as a case of recurrent pregnancy losses with history suggestive of cervical incompetence and on detailed investigation was found to be ANA and anti-cardiolipin antibody positive and Rh negative. We performed an interval laparoscopic cervical cerclage for her and were able to successfully deliver her at 35 + 3 weeks with a healthy baby by caesarean section after previous five pregnancy losses and two failed Mc Donald's cerclage.

Awareness Regarding Medicolegal Aspects of Medical Services Among Reproductive Age Women: A Population-Based Cross-Sectional Study.

The government has implemented various laws to regulate medical practice and improve the quality of health care services. This study evaluated the general population's awareness of various medicolegal aspects related to the medical profession.   Methods: A cross-sectional study was conducted.

Ureterovesical Leak Following Renal Transplant and Effects of Acute Rejection and Antirejection Therapy: A Nested Case-Control Analysis and Outcome of 1102 Consecutive Renal Transplant Recipients.

Objectives: Studies on nontechnical risk factors for ureterovesical leak after renal transplant are scarce. This study aimed to report the possible pre- and postoperative risk factors and the role of acute rejection and antirejection therapies for urine leak after transplant and its effect on graft and patient survival.

Materials And Methods: We conducted a retrospective analysis of 13 patients (1.

Laparoscopic Management of Disseminated Peritoneal Leiomyomatosis.

Study Objective: To show laparoscopic management of disseminated peritoneal leiomyomatosis (DPL).

Design: Stepwise demonstration of the technique with narrated video footage.

Setting: DPL is characterized by dissemination and proliferation of peritoneal and subperitoneal lesions primarily originating from smooth muscle cells [1].

Clinical value of second opinions in oncology: A retrospective review of changes in diagnosis and treatment recommendations.

Background: Data on the clinical value of second opinions in oncology are limited. We examined diagnostic and treatment changes resulting from second opinions and the expected impact on morbidity and prognosis.

Methods: This retrospective cohort study included patients presenting in 2018 to a high-volume cancer center for second opinions about newly diagnosed colorectal, head and neck, lung, and myeloma cancers or abnormal results.

A 5-year comparative study of efficacy and acceptability of three different sizes of TCu380Ag and TCu380A intrauterine devices.

Background: The intrauterine contraceptive device TCu380Ag when compared with TCu380A at 1 year of use had better acceptability and continuation rates.

Objectives: To study the continuation rate, efficacy, and acceptability of TCu380Ag in three sizes versus TCu380A at 5 years of use.

Methods: A total of 600 women opting for intrauterine contraceptive devices were randomized equally into two groups.

Role of Laparoscopic Transillumination Guidance During Hysteroscopic Metroplasty in Simplifying Surgical Management of Type II Robert's Uterus.

Robert's uterus is a rare variant of septate uterus with an asymmetrical septum which divides the uterine cavity into a noncommunicating hemiuterus causing hematometra and other communicating hemiuterus with a single cervix and a normal fundal contour (U2bC3V4 ESHRE classification). It is a cause of severe dysmenorrhea in young girls. However, there is a type of Robert uterus (Type II) which does not have collection in the blind cavity and causes symptoms later, similar to our case.

Consensuses, controversies, and future directions in treatment deintensification for human papillomavirus-associated oropharyngeal cancer.

The most common cancer caused by human papillomavirus (HPV) infection in the United States is oropharyngeal cancer (OPC), and its incidence has been rising since the turn of the century. Because of substantial long-term morbidities with chemoradiation and the favorable prognosis of HPV-positive OPC, identifying the optimal deintensification strategy for this group has been a keystone of academic head-and-neck surgery, radiation oncology, and medical oncology for over the past decade. However, the first generation of randomized chemotherapy deintensification trials failed to change the standard of care, triggering concern over the feasibility of de-escalation.

Laparoscopic Management of Partial Molar Caesarean Scar Ectopic Pregnancy.

Study Objective: To demonstrate laparoscopic management of a molar scar ectopic pregnancy.

Design: Stepwise demonstration of the technique with narrated video footage.

Setting: Cesarean scar ectopic pregnancy and molar pregnancy are 2 separate extremely rare pathologies with an incidence range from 1/1800 to 1/2500 of all pregnancies for the former [1,2].

Obstetrics outcome in pulmonary tuberculosis.

Background: To evaluate the maternal and perinatal outcome in pulmonary tuberculosis cases as compared to low risk pregnancies in a tertiary referral hospital.

Methods: A total of 15 cases of pulmonary tuberculosis over a period of two years who delivered in our unit was studied in the retrospective study. The maternal and perinatal outcome in them was compared with 191 low risk pregnancies who delivered at the same time in the hospital after taking into account inclusion and exclusion criteria.

Serum Bile Acids in Intrahepatic Cholestasis of Pregnancy (ICP), Versus Pregnant and Nonpregnant Controls in Asian Indian Women and a Proposed Scoring to Optimize Management in ICP.

Objectives: This prospective clinical trial was conducted to assess serum bile acids (BA) levels in women with intrahepatic cholestasis of pregnancy (ICP) compared to both pregnant and non-pregnant controls; and evaluate perinatal outcome in relation to bile acid levels. A scoring is proposed based on biochemical markers to optimize management in ICP cases.

Materials And Methods: Serum bile-acids(BA) were assessed in 71 intrahepatic-cholestasis of pregnancy(ICP) cases (group-I), versus 50 pregnant (group-II) and 35 non-pregnant (group-III) controls.

Urinary retention unveiling deeply embedded multiple leiomyomas in women with Mayer-Rokitansky-Kuster-Hauser syndrome and its successful laparoscopic management: a case-report and literature review.

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the second most common cause of primary amenorrhea with an incidence of 1:4000-5000 women. It is characterized by aplasia or hypoplasia of the uterus and the upper two-thirds of the vagina with normal ovaries and tubes and a normal secondary sexual characteristics. The occurrence of leiomyoma is common but it is rare to have leiomyoma in uterine remnant in MRKH syndrome.

Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) in predicting systemic inflammatory response syndrome (SIRS) and sepsis after percutaneous nephrolithotomy (PNL).

The objective of this prospective observational study was to assess the clinical significance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) as potential biomarkers to identify post-PNL SIRS or sepsis. Demographic data and laboratory data including hemoglobin (Hb), total leucocyte count (TLC), serum creatinine, urine microscopy and culture were collected. The NLR, LMR and PLR were calculated by the mathematical division of their absolute values derived from routine complete blood counts from peripheral blood samples.